Programmed Labor in Gestational Diabetes Mellitus as a Reserve for Reducing the Frequency of Cesarean Section

Abstract

The aim of this study was to investigate the perinatal outcomes of delivery by various methods in patients with gestational diabetes mellitus (GDM). Methods and Results: The study included 403 pregnant women (gestational age of 37.0–41.0 weeks) with GDM and 68 without disorders of carbohydrate metabolism, who gave birth from the second quarter of 2018 to the third quarter of 2020 in the maternity ward of the City Clinical Hospital No. 29 named after N.E. Bauman. All patients with GDM were divided into 2 groups. Group 1 included 187 patients receiving insulin therapy; Group 2 included 216 patients receiving a well-balanced diet. The main indicators of the health status of newborns in the early neonatal period were assessed taking into account the methods of delivery: programmed labor (PL), planned cesarean section (PCS), and spontaneous delivery. The 1-minute Apgar score in newborns from mothers of Groups 1 and 2 was higher at the PL, compared with PCS. The 5-minute Apgar score in newborns from mothers of Group 2 was also statistically significantly higher at the PL, compared with planned CS. The incidence of hypoglycemia in newborns from mothers of all groups was minimal at the PL, including a statistically significant low rate in newborns from mothers of Group 1. Symptoms of neonatal CNS depression were significantly more common in newborns born by abdominal delivery from mothers with GDM. Conclusion: PL in women with GDM reduces the incidence of the main complications of the early neonatal period: hypoglycemia and symptoms of neonatal CNS depression. PL may be considered more acceptable than abdominal delivery for women with GDM.

Keywords

• gestational diabetes mellitus
• programmed labor
• cesarean section